Minor Pain, Major Discovery: Pio’s Stage 4 Colorectal Cancer Story
Pio’s story is a reminder of how life can shift in the blink of an eye, even for someone who’s lived his days in sync with the ocean. Originally from Italy but a longtime Hawaii waterman, Pio spent decades windsurfing, surfing, and designing gear for the waves. He felt alive and in tune with nature, until a faint twinge near his liver led to a diagnosis that would change everything: stage 4 colorectal cancer.
Interviewed by: Taylor Scheib
Edited by: Chris Sanchez
Pio first noticed a minor pain, which he rated a “2 out of 10” and brushed off. But after a routine blood test in January revealed troubling markers, scans showed spots on his liver and lungs. Hearing the words “colon cancer” and “peritoneal carcinomatosis” was like stepping into another reality. Still, Pio’s mindset immediately leaned toward action and understanding. He and his wife Gretchen reached out to doctors across continents, eventually relocating to the Midwest with their daughter Allegra, so he could access specialized care.

Transitioning from long days in the Hawaiian surf to hospital visits in Oklahoma City and MD Anderson was a radical adjustment for Pio and his family. But his discipline and focus never wavered. Even as he underwent long chemotherapy sessions, sometimes walking out with a pump for two extra days, he leaned on his active lifestyle, nutrition, and mental strength. He fasted on chemo days, followed a mindful diet, and kept moving, believing that his body and brain together could support the treatment.
When scans in May 2025 showed tumor growth despite months of chemotherapy, it was discouraging. But Pio learned he carried the aggressive BRAF V600E mutation, prompting a targeted therapy with inhibitors. By July 2025, he was stunned to hear that the new treatment was working, a glimpse of hope that reaffirmed his belief in taking things one day at a time.
Through it all, Pio speaks with humility, love, and gratitude for his wife’s constant strength, his daughter’s resilience, and the community support stretching from Hawaii to Europe. He encourages others facing colorectal cancer to seek multiple medical opinions, stay actively involved in their care, and trust in their own inner power. He embraces the idea that mental discipline, connection, and self-belief are just as vital as medical treatment.
Pio now looks ahead with patience and purpose. His story reminds us that even in the face of something devastating, we can find ways to reconnect with ourselves and our loved ones, to learn, and to support others walking a similar path.
Watch Pio’s video and scroll down for his interview transcript for more about:
- How minor discomfort led to a life-changing diagnosis
- Why mindset and discipline became Pio’s greatest tools
- How one family faced colorectal cancer with courage and care
- The moment a routine check-up revealed something life-altering
- From the ocean to oncology: Pio’s empowering story of hope
- Name: Pio M.
- Diagnosis:
- Colorectal Cancer and Rare Form of Extensive Peritoneal Carcinomatosis
- Staging:
- Stage 4
- Mutation:
- BRAF V600E
- Symptom:
- Minor pain in liver area
- Treatments:
- Chemotherapy
- Monoclonal antibody medicine
- EGFR inhibitor
This interview has been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider to make informed treatment decisions.
The views and opinions expressed in this interview do not necessarily reflect those of The Patient Story.
- My name is Pio
- When I first noticed something was wrong
- The moment everything changed
- We left Hawaii to find the right care team
- What my treatment has looked like
- I found out I have an aggressive mutation
- What cancer has shown me
- Adjusting to life on the mainland
- Why I feel like multiple opinions are important
- What I want people to know
My name is Pio
I am originally from Italy. I have lived in Hawaii for 35 years, and I am a surfer, windsurfer, and waterman. I dedicate my life to water sports. I have my own company, and we design surfing and windsurfing accessories.
I was diagnosed with an adenocarcinoma in the colon that basically moved to the peritoneum. So I have peritoneal carcinomatosis and little lesions in the liver, in the subcapsular of the liver, and two small nodules in my left lung.
When I first noticed something was wrong
In the last two months before the diagnosis, I was still training, still surfing, still being in the water, swimming, windsurfing, but I was not feeling 100% for some reason. I did not connect those feelings to anything serious. Even if I am 54, I am still training, I am still healthy, and trying to follow certain diets. So I did not really think about it, honestly. I was like, “Yeah, I just do not feel 100%, whatever.”
Then right after, right before the 7th of January, I had this very small pain here, on my liver. From 0 to 10, it was like 2. I honestly kept doing what I was doing, just going over the pain because it was not a major pain, and I did not pay attention, honestly.
I went on the 7th of January to do the classic yearly blood test that I do. I asked the doctors, “Since I am here, do you guys want to check? I have this little pain.” They were like, “Yeah, no problem.” When I went in, the doctor was like, “You do not have any long medical history. You do not take medicines. You are kind of a little bit off the data here. But why do you have this? Why do you have this pain here? I do not like this.” He was straight, and he was like, “I want you to do more tests. Do you have time?” I am like, “Yeah, no problem.”
So I did another blood test right after, and they took some different markers. One was the D-dimer. I think it is called the D-dimer. It was basically because he thought that it was a blood clot that had formed. After all, I was traveling for a couple of months right before, on the plane. I was in Asia and then in Australia, then I came back, and he was like, “Wow, maybe you have a blood clot. Let’s check.” The marker came out super high, and he was like, “You might have a blood clot, as I said. So let’s do a chest scan, see how you feel.” I am like, “Okay.”
So I went in, did the CT scan, came back, and I was waiting for him. He comes in with one of those faces. He was like, “Well, the good news is you do not have a blood clot. The bad news is I see these couple of black spots that I do not like.”
I froze, because you do not want to ask that word, and you do not want him to tell you that word. We both looked at each other, and he was like, “I am going to have to do another scan of your pelvis.” I was like, “Is that cancer?” He was like, “I cannot tell you until I have the other scan.”
So I went in again, and meanwhile, I called my wife. I was like, “Something happened.” We were supposed to leave three days later because she had a European tour. I was going to go visit my mom and my family, and then she was going to go on tour, and I was going to go catch her when I could. We were ready to go. So Gretchen came, and we were there. You can imagine, before going into the scan, we were turning things over in our heads. We were like, “What is happening?” It is a shock.
The moment everything changed
So I went to do the other scan, and when I came in, he came with the classic face, looking at the ground.
I was like, “What is happening?” He was like, “Well, you have colon cancer, and you have peritoneal carcinomatosis.” For me, it was like, “What is this word?” I understand colon cancer, but peritoneal carcinomatosis? “You have this in the subcapsular of the liver.” So I am like, “Oh my God.”
From there, he expedited me to Honolulu to do a colonoscopy right away because they could not do a colonoscopy in my local hospital. I flew on Friday to Honolulu. We came back home on the 7th, and I think it was Tuesday or Wednesday. Imagine the first two days: I was like, “What do we do? What are we doing?” It is a very hardcore type of feeling. It is very hard to explain. It comes from the core. You start saying, “Okay, I am healthy, I am doing this, I am doing that. Why is this happening to me?”
When I was having the conversation with the doctor, the doctor was looking at me like, “You do not feel anything?” I am like, “No, I went for a run yesterday. I was in the water all last week.” He was like, “You do not feel symptoms?” I was like, “No, that would be earlier.” He was like, “Well, it is kind of advanced, and I am going to send you to Honolulu so we know exactly what it is.”
So when we came back home, it was just a couple of days or less. Complete shock. We did not know how to tell our daughter.
We left Hawaii to find the right care team
I started to make phone calls, and my first idea was, “Okay, I am going to call Italy.” I know doctors and friends right away who could tell me what to do. As soon as I pronounced the word “peritoneal carcinomatosis,” they were like, “Oops.” I was like, “What is up?” They said it is kind of rare and especially in men. It is not something that you see often, and especially as we can read here, it is an extensive carcinomatosis. We need to get this aggressively now.
I asked, “Do I need to go there?” He was like, “No, you have the best centers in the United States. You have to call these people. Call MD Anderson. Figure out where to go.”
So I talked to my wife, and I was waiting. “Okay, let’s see if the hospital in Maui can tell me something.” I called. They did not call me back. The classic thing. I am not the person who is going to sit on a chair and just wait. I approach my life always very straight, head-on. So my wife made some phone calls, I made some phone calls, and we basically got accepted. I got accepted into Oklahoma City through some friends. So in eight days, I packed my bag and boom, I left. I arrived in Oklahoma City. I went to see the doctor.
She started to talk to me about my diagnosis and the options that I had, and she sent me straight to a PET scan. After a couple of days, she was like, “Well, these lesions are growing. Luckily, you do not have it anywhere else. Your bones are fine, your brain is fine, everything is fine. But I want to start treatment with you right away.”
I left Hawaii nine months ago. I never came back. I have not come back yet because right now I am based in the Midwest, so I can be close enough to go to Oklahoma City. I am in Kansas. I can go to Oklahoma City for treatment. After a couple of weeks, I got accepted at MD Anderson, which I am very grateful for. I was lucky to have that. I went there for the first time at the end of February, then I went back in March. The doctor there had the same face: “You have something serious, which is stage 4, obviously. It is something serious that we really need to be aggressive about.”
What my treatment has looked like
I was doing this long session of chemo, about 6.5 hours, then going back with the pump for two days at home. I was staying in a B&B in Oklahoma City. I would stay for a month there because I was doing therapies every two weeks, but I was seeing the doctors. The doctors wanted me there. “If something happens, I want you here. I do not want you to go anywhere.”
From there, the chemo started to work a little bit, so my anxiety started to go away. I started to feel a little better. I was like, “Okay, this is working.” I was very lucky not to have major side effects, also because I was following a food program already with one of my nutritionists. The day before chemo and the day of chemo, I was fasting. I was just drinking bone broth and maybe eating some millet, stuff that was not really heavy. Obviously, completely out of sugar, and I am a sugar addict. This really helped. I really suggest listening to your body.
I was still going out and walking, still going to the gym when I could, because I could not stop. I am like, “I am not going to give up right now.” That is the thing that really helped me throughout my life: my mindset. It has always been very straight and very direct. If I have to do something, I am just going to do it with 150%.
I found out I have an aggressive mutation
After the sessions, in May, I went down for my second scan at MD Anderson to see the doctor. I was feeling slightly better, so I was like, “Hey, this is going to be great.” You have these expectations, which I learned my lesson about.
The doctor came back, and she was like, “They actually grew. They grew.” “What do you mean?” She was like, “Yeah, unfortunately.” Because I was feeling some nodules here when I was passing my hands. I was like, “I do not feel these nodules anymore.” She said, “I cannot tell you that we can go by what you feel with your hands. The thing grew a bit. I am a little worried the therapy did not work because your markers are high.”
I was like, “What do you mean? But I feel better than two months ago.” She said, “I understand. You are definitely not in the statistics. If you feel better, that is good, but we cannot just go by that.” You start to understand how my body works. We had a conversation about how I feel. “I feel better.” She said, “I am going to have to switch the therapy. I am going to put you on some inhibitors, because you also have, in addition to your cancer, a BRAF V600E gene mutation, which basically is very aggressive.”
So she put me on an inhibitor for the gene and then another therapy, which is a one-and-a-half-hour infusion every week. That is an inhibitor of the EGFR protein that basically reproduces the cancer cells. I was like, “Is this going to work?” She said, “I do not know.” “What do you mean?” She said, “I do not know. I really hope that this is going to work.”
My wife and I were looking at each other. “Okay, let’s dive in again into this other adventure.” That is where my mindset helped me so much. “Okay, I am just going to live this day by day, as I have been doing.”
From there, in July, I went to another scan, and everything just changed radically. The doctor was like, “What happened?” I was like, “I do not know.” She was like, “This is getting better. The therapy is working.” I was like, “Okay, what do we do? Surgery? Can I do this?” She said, “Chill out. We can talk, maybe at the end of the year.” I said, “The end of the year?” She said, “We have to do one step at a time.”
What cancer has shown me
I feel that I am having this experience, whatever the end of this experience will be, because I am learning. I am reconnecting with a lot of other people. I am connecting more with my family. I am connecting more with my people at work. I had huge support from the entire community, from Hawaii, from Europe, from everywhere. You do not expect it. You know it can be there, but you do not know how big it is going to be. That was huge.
At the beginning, you ask these questions: “Why me? Why? I am so happy, I am so good, I can swim for hours, I can do this, I feel like I am a superman.” No, you are not. You are not healthy. You were fit. As much as you eat well, as much as you do everything I was doing, I was asking these questions. I do not know why. I do not know why. Sorry. I do not know why this happened to me. I do not know why this is my reality. The reality is, I did not give myself an explanation.
I just got to the point: first of all, better me than my daughter. Better me than a five-year-old kid. Better me than my wife, even if my wife is an incredibly strong being. Without her, there is no way I would go through this. Thank you, Gretchen. She is a powerhouse. I just went in, and I am like, “Okay, it is a plan. This is a plan. It was written, and I am just going to have to accept it. I am going to make treasure and learn from it.”
Adjusting to life on the mainland
Allegra, my daughter, was like, “What am I doing here?” I was like, “Good question.” So it is a radical move. Two places are totally different. But obviously, I needed to find care and people who actually care about what I was going through. The main thing is, first of all, as I said, the first couple of months, you are completely confused.
We, Allegra and I, were like, “Okay, I want to go to school.” I am like, “Great.” So she ended up in the school where Gretchen was raised. She had to do the last three months of middle school. Imagine this little girl who was still 13, because she turned 14 on March 25th. She basically just turned 14.
She used to go to jungle school, kind of Waldorf method, barefoot, no screens, in the jungle, classes of eight kids, everybody helping each other. Different ages, that type of method. Take this little girl, put shoes on her, jeans, move her into a 300–400 student school, and she is like, “What am I doing here?” Obviously. For us, that was our main concern, because we are adults. We are going through a hard moment, but our concern is our daughter.
Talking to her, and obviously, you have this thing at the beginning where you feel that your daughter is not upset with you, but she feels it is your fault. “I want to be with my friends, and I am here because this is what is happening.”
For me, being away from the ocean is not ideal. People think, “Oh, you live in Hawaii, you are all day on the beach.” No. We work hard, we play hard, but we work hard. The beauty of Maui, or living in a place like Maui, is like, “Oh, there are some waves, or there is wind, I am going to go for half an hour or an hour and come back to my office and work.” That is something I did not have anymore.
As I said, patience is one thing that I am trying to teach my daughter, and patience is the thing that you increase every day. You are thankful because you are still here, and it does not matter where you are; you are going to come back. Hawaii is still going to be there. The ocean is still going to be there.
Why I feel like multiple opinions are important
I think that multiple opinions are a must. Honestly, you do not want to just listen to one person, not because that person is not good—that is not what I am saying—but you also need to learn. Luckily, I was already very in tune with my body. I already knew a lot of things about how my body works. So my conversation with my first doctor was like, “Okay.” I was documenting myself, trying to understand what this peritoneal carcinomatosis is that everybody was worried about.
Then I started to learn and understand so I could have a conversation. The reality is that I believe different people also communicate with each other. There are different care teams, which is amazing. There are different apps. They can communicate, and they share. All of them have a different way to talk to you.
You learn different things. Plus, I am the classic person: I go there with my phone and ask 20,000 questions. But that is because I want to learn, and I want to confront myself and learn and have them communicate. I believe it is a must.
What I want people to know
First of all, you are special. This does not happen to everybody. It is you. Especially in a good and in a bad way, unfortunately, to have this, and there is a lot to learn. The main thing, I think, is to take it head-on. Do not get depressed. Do not think that you are not going to make it. I understand that at the beginning, that is what you think. I felt the same. But then, when you get into the groove, just be focused on yourself and be convinced.
We are very powerful beings. My doctor at MD Anderson told me a very nice thing: “There is so much I can do. I feel we do 50%. The other 50% comes from you.” And I was like, “I knew it.” That is the thing: you have to believe at the cellular level—your body, your brain. When you believe, you feel better. You create oxytocin. You create all these chemical things in your body. It makes you feel better. You need to look for good support, a medical team, but you need to believe that you are going to get through this and see what is going to happen.
You are going to learn from it. Because when you go through this, your brain changes a bit. You have this change, this little modification in your system. I feel, “I was helped. Okay, now it is my turn to help, and then it will be the turn of this other person to help.”

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